Endovascular treatment of acute ischemic stroke (AIS) and mechanical thrombectomy (MT) is proven as a safe and effective novel treatment for emergent large vessel occlusion in the anterior cerebral circulation. However, there are still many unanswered questions on peri and post-procedural management including blood pressure (BP) control. The current guidelines recommend maintaining BP <180/105 mmHg in the first 24 h after MT. However, recent studies suggest that maintaining BP levels at lower levels in the first 24 h after successful revascularization have been associated with favorable functional outcome, reduced mortality rate, and hemorrhagic complications. Not only absolute BP but also its variation in the first 24 h after MT have been associated with neurological outcomes. Evidence on the effect of BP variability (BPV) after MT in AIS even though limited, it does indicate the association of the higher BPV in the first 24 h after MT and poor functional outcomes in AIS. In this review, we will discuss the current literature on BP management in the first 24 h after MT and the impact of BPV in the first 24 h after MT.

中文翻译：

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脑卒中患者机械取栓后的血压管理

急性缺血性卒中 (AIS) 和机械取栓 (MT) 的血管内治疗被证明是一种安全有效的新疗法，用于治疗大脑前循环中的紧急大血管闭塞。然而，在包括血压 (BP) 控制在内的围手术期和手术后管理方面仍有许多悬而未决的问题。目前的指南建议在 MT 后的前 24 小时内保持血压 <180/105 mmHg。然而，最近的研究表明，在成功血运重建后的前 24 小时内将血压水平维持在较低水平与良好的功能结果、降低的死亡率和出血并发症有关。不仅绝对血压而且其在 MT 后前 24 小时内的变化都与神经系统结果相关。关于 AIS 中 MT 后 BP 变异性 (BPV) 影响的证据尽管有限，但它确实表明 MT 后前 24 小时内较高的 BPV 与 AIS 中较差的功能结果之间存在关联。在这篇综述中，我们将讨论目前关于 MT 后前 24 小时血压管理的文献以及 MT 后前 24 小时内 BPV 的影响。